title: Impact of the fracture risk assessment on patient and physician behavior in osteoporosis prevention.
abstract: OBJECTIVE
  To evaluate the impact of a pharmacist-directed osteoporosis screening program utilizing the fracture risk assessment (FRAX) tool on patient and physician behavior.
  
  
  METHODS
  Postmenopausal women 45 to 65 years with Achilles T score <-1.0 not receiving bisphosphonate therapy were randomly assigned to a control or intervention group. All participants received a heel ultrasound and pharmacist education on risks of low bone mass. The intervention group received the FRAX and shared their results with their physician. Three months after screening, a telephonic questionnaire was administered to all participants.
  
  
  RESULTS
  A total of 749 patients were screened, with 87 meeting the enrollment criteria (43 control and 44 intervention). Physician behavior was not different between the groups with respect to ordering vitamin D levels, prescription medication, or dual-energy x-ray absorptiometry scan. A significant difference in vitamin D supplementation occurred between the 2 groups (P = .024). At follow-up, 72.2% of responding participants increased daily calcium intake and 76.4% started or increased physical activity.
  
  
  CONCLUSIONS
  Physician behavior was not influenced by FRAX results in the intervention group; however, positive patient behavior changes occurred in both groups. Primary prevention efforts conducted through heel ultrasound screening and pharmacist consultation led women to follow-up; however, awareness still needs to be raised of the value of FRAX in osteoporosis prevention.
authors.affiliation: Duquesne University, Pittsburgh, PA, USA.
authors.forename: Jamie L
authors.initials: JL
authors.lastname: McConaha
authors.forename: Hildegarde J
authors.initials: HJ
authors.lastname: Berdine
authors.forename: Monica L
authors.initials: ML
authors.lastname: Skomo
authors.forename: Robert V
authors.initials: RV
authors.lastname: Laux
authors.forename: Suzanne K
authors.initials: SK
authors.lastname: Higginbotham
authors.forename: Christine K
authors.initials: CK
authors.lastname: O'Neil
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D015519:Bone Density; D002118:Calcium / Q000008:administration & dosage; D019587:Dietary Supplements; D005081:Exercise Therapy / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000150:complications*; D010353:Patient Education as Topic / Q000379:methods; D010595:Pharmacists / Q000458:organization & administration; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D018570:Risk Assessment / Q000379:methods; D016037:Single-Blind Method; D011795:Surveys and Questionnaires; D014807:Vitamin D / Q000008:administration & dosage
chemical_list: D014807:Vitamin D; D002118:Calcium
keywords: bone fractures; clinical pharmacists; osteoporosis; preventive medicine